肥胖与非肥胖患者大隐静脉剥脱术后中期效果比较

The mid-term outcomes of stripping great saphenous vein in treatment of varicose vein of lower extremities for obese patients compared with the non-obese ones

目的探讨肥胖与非肥胖患者行大隐静脉剥脱术后中期效果的差异。方法选择2012年7月至2013年12月,在承德医学院附属医院因下肢浅静脉曲张并接受大隐静脉剥脱术的患者为研究对象。随机抽取30例肥胖患者(体质量指数≥28 kg/m^2)为肥胖组,以年龄、性别、静脉临床症状严重程度评分(VCSS)及股静脉反流情况为参照,以1∶1匹配非肥胖患者作为非肥胖组。比较两组患者中期随访结果。结果两组患者平均随访13.1个月。肥胖组患者持续穿戴弹力袜的时间短于非肥胖组(P<0.05)。随访中,所有患者VCSS及Aberdeen静脉曲线问卷(AVVQ)评分均较术前有明显改善,但肥胖组AVVQ评分高于非肥胖组(P<0.05);而VCSS评分,两组间比较,差异无统计学意义(P>0.05)。术后股静脉反流的改变情况,两组间比较,差异也无统计学意义(P>0.05)。结论下肢静脉曲张合并肥胖患者行大隐静脉剥脱术后至中期阶段,相应体征及生活质量均能得到明显改善,但患者主观症状的改善程度劣于非肥胖患者,这可能与前者术后穿戴弹力袜的时间相对较短有关。而在股静脉反流的改变方面,肥胖可能并非重要影响因素。

Objective To investigate the midterm outcomes of stripping of great saphenous vein（ GSV） in treating varicose vein（ VV）of lower extremities in obese patients by comparing to the results from non-obese patients. Methods A retrospective study was performed on obese patients with VV in lower extremities that underwent stripping of GSV received in the Affiliated Hospital to Chengde Medical College from July 2012 to December 2013. Patients（ body mass index more than 28 kg / m^2） were randomly divided into the obese patients group（ n = 30） and non-obese group according to 1∶ 1 matched for age,gender and venous clinical severity score（ VCSS）and the reflux condition of femoral vein. The clinical data of the two groups of patients with median follow-up results were compared and analyzed. Results The mean follow-up time in the two groups was 13. 1 months. The duration of wearing elastic stocking in the obesity group was shorter than that in the non-obesity group（ P〈0. 05）. VCSS and the scores of AVVQ were better in all cases. The scores of AVVQ in obesity group was higher than that in the non-obesity（ P〈0. 05）,while the VCSS score showed no statistic difference in both groups（ P〉0. 05）. As to the changes of the reflux of femoral vein,no significant difference was observed（ P〉0. 05）.Conclusion In the mid-term,the physical signs as well as the living quality of the obese cases with VV of lower extremities are improved obviously,while the improvement degrees of their subjective symptom are inferior to that of the non-obese cases. This result could be due to the shorter duration of elastic stock wearing in obese cases. As to the reflux of femoral vein,obesity may not be an important impact factor to influnce its changes.